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Introduction: Countries must employ the most efficient way to vaccinate their population with the COVID-19 vaccines, given the vaccines' low availability compared to its demand. This review aims to identify and compare the different COVID-19 vaccine delivery strategies employed internationally in the recent year based on the economic evaluation findings and subsequently to recommend the most cost-effective strategy among them., Material and Methods: A systematic review was conducted by examining online databases (Scopus, MEDLINE and Science Direct) to identify health economic evaluation studies of COVID-19 vaccines. Critical appraisal of studies was conducted using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS)., Results: A total of nine studies were selected for analysis. Results show two strategies that were cost-effective compared to its comparators: mass vaccination program compared to no vaccination and universal vaccination approach compared to a risk-stratified vaccination approach. Several other strategies were found to increase the cost-consequences in the COVID-19 vaccination program: higher vaccine effectiveness, higher vaccination pace, increased vaccination coverage, and vaccine prioritisation for an at-risk population. The study findings were restricted to analysis based on the current available data., Conclusion: COVID-19 vaccination policies should aim for increased vaccine production as well as a rapid and extensive vaccine delivery system to ensure the maximal value of vaccination strategies. These results can aid policymakers in opting for the most efficient approach to vaccinating the population during this COVID-19 pandemic and future pandemic.

Introduction: Healthcare workers (HCWs) were among the first to be fully vaccinated against SARS-CoV-2. However, the antibody responses to the vaccines and potential decline among Malaysian HCW are still unclear. The objective of this study is to follow-up anti-S antibody levels among HCW vaccinated with mRNA vaccine (BTN162b2) and inactivated vaccine (CoronaVac)., Materials and Methods: Plasma samples were collected prevaccination, 2 weeks and 6 months post-vaccination and tested for total immunoglobulin levels using ELISA method., Results: A small percentage of HCW (2.2%, 15/677) had elevated anti-S antibody levels in their pre-vaccination plasma samples (median 20.4, IQR 5.8), indicating that they were exposed to SARS-CoV-2 infection prior to vaccination. The mRNA vaccine significantly increased anti-S levels of both previously infected and uninfected individuals to saturation levels (median 21.88, IQR.0.88) at 2 weeks postsecond dose of the vaccine. At 6 months post-vaccination, the antibody levels appeared to be maintained among the recipients of the mRNA vaccine. However, at this time point, anti-S antibody levels were lower in individuals given inactivated vaccine (median 20.39, IQR 7.31, n=28), and interestingly, their antibody levels were similar to anti-S levels in pre-vaccination exposed individuals. Antibody levels were not different between the sexes., Conclusion: Anti-S levels differ in individuals given the different vaccines. While further study is required to determine the threshold level for protection against SARSCoV- 2, individuals with low antibody levels may be considered for boosters.

Background: Economic evaluations of vaccines are important to assist in the selection of the most costeffective vaccine. This scoping review aims to systematically explore and catalogue the methodologies and outcomes of economic evaluations of COVID-19 vaccines, with a focus on assessing their presence and representation in Arab countries. The review seeks to identify methodological diversity and potential research gaps to inform future studies and healthcare policy decisions in the region. Materials and Methods: The review methodology involved searching major databases for articles published in English from 2020 to 2023. Keywords used included "COVID-19 vaccine", "economic evaluation", "cost-effectiveness", and related terms. Studies were included if they performed any form of economic evaluation related to COVID-19 vaccines. Exclusion criteria were non-English articles and studies not employing economic evaluation methodologies. Result: The review included 29 studies with significant variability in methodology. Majority (n=15) of the studies were CUA, applied static models (n=13), used QALY as outcome measure (n=11), used short time horizon (< 1 year) (n=21), used healthcare perspective (n=13), conducted sensitivity analysis (n=29), direct medical costs were mostly vaccination costs and hospitalization (n=29), and considered indirect costs (n=8). Notably, none of these studies specifically addressed the Arab region. Conclusion: The diverse methodologies employed in the economic evaluations of COVID-19 vaccines suggests the necessity for standardization and consensus in research approaches to better compare outcomes and optimize vaccine distribution strategies globally. The absence of region specific economic evaluations in Arab countries underscores a critical gap in the literature. This review highlights the need for targeted economic research to support effective vaccine deployment and policymaking in the Arab world. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic has tremendously caused significant health impacts leading to high load of ICU critical patients. Multiple Intensive Care Unit (ICU) admission framework and triaging score have been adapted worldwide for admission of COVID-19 patients. The aim of this article is to review the COVID-19 ICU admission policy in five (5) countries, identify challenges and provide recommendations. Materials and Methods: Literature review was carried out through searching available literature from online databases such as EBSCO, PubMed, Research Gate, Google Scholar and Google search engine. The selected information used in this review is taken from any journal, article, report, thesis, national report, news update regarding the topic. Result: The ICU admission policy in 5 countries, namely South Africa, USA, UK, Hong Kong and Malaysia were reviewed. Different countries apply different guidelines to triage, prioritize and admit severe COVID-19 patients to ICU such as Color-coded Priority Scale in South Africa, Critical Care Triage Tool in USA, COVID-19 Critical Care Guideline in UK, COVID- 19 Critical Care Triage Tool in Hong Kong and ICU Admission Prioritization Criteria in Malaysia. The ICU admission decision-making is supported with multiple ICU scorings such as Sequential Organ Failure Assessment (SOFA), Clinical Frailty score and National Early Warning score 2 (NEWS2). Conclusion: The COVID-19 ICU admission policies in these countries are well established and have been practised appropriately despite challenges faced by the ICU practitioners. All five selected national guidelines in this paper correspond to the WHO framework on the ICU admission policy. Ethical issues and legal supports on the ICU practitioners in ICU admission decision-making requires great attention form government and relevant policy stakeholders. [ABSTRACT FROM AUTHOR]